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ELECTRICAL PER�IAIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> AFPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> -j 'l "'` <br /> � � t �lA�\ �.�(� �''� <br /> ' `' C'� r \``.C �� � <br /> PROJECT ADDRESS <br /> �1��:� \C��� l.w ��1'l��V �:,L �C��'� ��. �UZ��� � � � — � Z� �- <br /> Owner Mall Address Clly State2ip Phone <br /> Tenanl h1ail Address Cily Stale/Zip phonc <br /> ��\�_�,��� i��_��� , L� ��-,�-,�_ L���-:�� ��,Z _ �-I � �, � <br /> Eleclrical ConU���or Mail Address Clly Stale2ip Phone <br /> ��,\L,��T N1.= LLl��' ? i\�.� <br /> Stale License Nwnber � ' Contracl Prico ot Work <br /> Proposed Uso of 8uildinc� Contacl Person (Plan Review) <br /> DescripUon of Work to Oe Done: � ��� � �. A �' \\�y'L!, � � L'�..{ �V%-V���J��,� <br /> 1��� ( � �. _ �� i <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � �, �l—' <br /> ��` <br /> I CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> I hereby cerii(}�fhat I have rend and exnmined this npplica(ion ond know fhe same to bo tnre and <br /> correct. All provisions o/lan�s and ordinances goveming fhis fype ol work will be complefad <br /> rehefher spea�ed herein or noL The�ranfing oI a pernuf does not presumo fo�i�-e aufhonty to <br /> violate or canr.el fhe nrovisions o(�n}�olher sfafe or locol lo�v ret�u/nfing consfruction orthe <br /> performance ol constiuction. Thaf 1 am aufhorized by fhe omner ol this property fo perfomi fhe <br /> �vo�k lor rohich appficafion is made and I cnmpty u�i(h the Slate Contracfors Lau� 18.27 RCll�and <br /> 29G.200 WAC. <br /> ���?� `� � ' �' � `�`-' <br /> � <br /> igna uro Date I <br /> 1`0 i0�-( CJ57 <br />